Tuesday, August 12, 2008

News From the Birth World

Many of these links came to me courtesy of Rixa at the True Face of Birth, one of my favorite birth blogs.

A few are cross-linked from other articles, and as such may not be especially recent, but they are relevant.

Here goes:

TIME magazine has an article on homebirth. Citizens for Midwifery has a guide to writing a letter to the editor to express your support, since, as they put it, just about any publicity is good publicity at this point. I don't know that I'd go quite that far, but I understand the sentiment. My take on TIME's article? Not nearly as bad as some they've written, but in my opinion, equally weak reporting and overall journalism. It includes the now-standard fare in the media's coverage of birthing options: some women are ardently pro-homebirth, some doctors are ardently against it. Birth centers may be a happy medium, but they're closing due to high malpractice premiums. [Note on content and accuracy: no mention is made of whether these malpractice premiums should be questioned in light of the generally favorable outcomes (and low rates of liability) birth centers maintain. It also appears to conflate hospital-associated birth centers (which may just be fancily decorated labor and delivery units, which ascribe to the same model of care as any other hospital birthing facility) with freestanding birth centers.] The article states, "But what might seem like an ideal solution has run into roadblocks, as a few prominent centers have closed in recent years because of high malpractice-insurance costs--which means many natural-birth seekers will still have to choose between hospital and home."

AND...that's it. What kind of a limp conclusion is that? You conclude the article with the exact same question you opened it with, completely ignoring the fact that within the article, the issue was raised that doctors are trying to legislate away homebirth with a midwife as a valid option, thereby negating the very choice being discussed. So basically, we've laid out a few facts (several of which were inaccurate to various degrees), advanced the discussion not at all, and then just stopped writing. No conclusion, no food for thought, just a period at the end of another sentence.

Dr. Mike Hargadon, candidate for Congress in District 7, questioned last month’s decision by the American Medical Association (AMA) to support proposed legislation that could outlaw planned homebirths.“Is this about safety or better birth outcomes? No, it’s about money and it’s about the AMA trying to protect its turf, plain and simple,” said Dr. Hargadon.“Study after study has shown that births attended by midwives outside of a hospital are just as safe, and maybe even safer, than hospital births.”

Elaborating on why the AMA would support such legislation, Dr. Hargadon continued, “Midwifery is a fast-growing industry.More families are choosing to have births attended by a midwife, rather than by an OB/GYN.It also costs significantly less to give birth outside of a hospital setting.So it comes as no surprise that the AMA would support making homebirthing illegal.They’re losing money and losing market share.”

Dr. Hargadon made it clear that he strongly opposes this attack on freedom and entrepreneurship. “Here you have a group of women who are successful and doing what they love. We need more of this in health care, not less. Midwives are giving people what they want and doing it in an affordable way. But the AMA wants to tell us it isn’t safe, and run these successful women out of business or make them subservient to AMA. It’s blatantly sexist, it’s anti-freedom, and if this legislation passes, it will increase prices.”

Dr. Hargadon expressed relief that no legislation has been drawn up yet, but was wary about what the future may hold.“My hope is that the Congress wouldn’t be so foolish as to try to legislate birth choice. But if you want to know what Congress will do, just follow the money.In this election cycle alone, the AMA Political Action Committee has donated almost $740,000 to Congressional candidates and other party committees. My opponent, Congressman Elijah Cummings, has received $5000 in donations from them in the past four years.So my fear is that the AMA has already bought this legislation.”

He ended on a personal note.“Many families, including my own, have decided that they’re unhappy with the traditional hospital birth experience and find that midwives give them a better experience for low-risk births.My first child was born in a hospital over 30 years ago, while the doctor was complaining about missing the Colts’ game and trying to induce labor. So our next three children were born in the presence of midwives. The births of those three, who were born at their own pace, were a much more beautiful life experience than a time management ‘problem.’ ”

We so need more articulate, intelligent, high-profile people adding their voices to this debate! Thank you, Dr Mike Hardagon!

And finally, two conflicting articles on elective induction of labor. One involves the idea that inducing labor at an "ideal time" may lead to fewer C-sections. It details one study which shows some correlation (though not causation, warns the study's author) between these ideas. My problems with this? What's an "ideal" time for one baby may not be ideal for another; and I can confidently say that this is just another justification for physicians to induce labor at the drop of a hat at a time that's ideal for THEM. The inductions I see lead to C-section so much more often than the cases of spontaneous labor do, and elective induction in general leads to a doubled risk for Cesarean in first-time moms. While the article in question mentions using timed induction as a way to cut the Cesarean rate, it ignores the very real fact that doctors aren't interested in cutting the Cesarean rate. It saves them time, makes them money, and gives them an edge in malpractice suits. Absent a respect for natural childbirth, why would they? The other article details some of these concerns, and the health risks faced by "late preterm" infants, or those born before 39 weeks--reinforcing the common-sense idea that we shouldn't interfere in a natural process unless there's a good reason to do so.

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